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The Face We Put Forward: Experiences and History of Facial Feminization Surgery

Facial feminization surgery allows trans folks to grow more comfortable with their outward appearance and navigate the world in the way they always hoped to.
Facial feminization surgery allows trans folks to grow more comfortable with their outward appearance and navigate the world in the way they always hoped to.

Outward appearances play a big role in our perceptions of gender. Some of us have the privilege to not think too much about it. But for some trans folks, the way that others perceive their gender has implications for their mental and physical health. That leads some to pursue changes like facial feminization surgery — a series of procedures that shape brows, cheeks or chins to appear more feminine — to align internal and external appearance.

Host Anita Rao talks with Emma Ward, a songwriter, producer and community manager, about her experience getting facial feminization surgery. And Eric Plemons, associate professor of anthropology at the University of Arizona, shares the history of the surgery and its significance in shaping how we perceive sex and gender. Plemons is the author of “The Look of a Woman: Facial Feminization Surgery and the Aims of Trans-Medicine.”

Interview Highlights

Ever since I started my transition, I always wanted [facial feminization surgery] … I just wanted to knock out everything so that when I get older, I don’t have to go through the process. Zuriah Lee

Emma Ward on discussing her desires for her face with her surgeon: 

I think there's been kind of an evolution of how surgeons approach these kinds of procedures to make sure that everybody walks out looking natural. And, you know, they don't look like they were molded in clay or anything. [My surgeon] was very focused on that. I think that was a big part of the reason why I chose to work with him, because he didn't want to do things that would, you know — that maybe I wanted, but wouldn't actually work with my features.

Having the surgery was really important for me to feel better about myself. No matter what your journey, having self confidence will allow you to flourish. I truly feel that in life if something will make you happier then you should go for it. Capri Celia

Eric Plemons on the demand for facial feminization surgery:

If gender is a social product, it's something that we give to each other through social exchange, then the most meaningful change that a trans woman can make in her body is not in the hidden parts of it, but in the parts that everybody sees. And so I met people, all the way from their early 20s to their late 60s, people who had come to their trans identities late in life, or people who had just finally decided that after many years of waiting to have a procedure done ... [and those] people told me stories of wanting to look in the mirror and see the person that they knew themselves to be looking back at them.

My advice is this: First, take lots of pictures. And secondly, give yourself time. Because you’re going to be swollen like a pufferfish when the surgery is first completed. And your face will change over the coming weeks, months and years. Give yourself time to relax and enjoy the process. Surround yourself with good people. Maybe take a few painkillers. You’ll be fine. Aluna Vayne

Please note: This episode originally aired November 5, 2021.

Copyright 2022 North Carolina Public Radio. To see more, visit North Carolina Public Radio.

Anita Rao is the host and creator of "Embodied," a live, weekly radio show and seasonal podcast about sex, relationships & health. She's also the managing editor of WUNC's on-demand content. She has traveled the country recording interviews for the Peabody Award-winning StoryCorps production department, founded and launched a podcast about millennial feminism in the South, and served as the managing editor and regular host of "The State of Things," North Carolina Public Radio's flagship daily, live talk show. Anita was born in a small coal-mining town in Northeast England but spent most of her life growing up in Iowa and has a fond affection for the Midwest.
Kaia Findlay is a producer for The State of Things, WUNC's daily, live talk show. Kaia grew up in Minneapolis, Minnesota, in a household filled with teachers and storytellers. In elementary school, she usually fell asleep listening to recordings of 1950s radio comedy programs. After a semester of writing for her high school newspaper, she decided she hated journalism. While pursuing her bachelor’s in environmental studies at UNC-Chapel Hill, she got talked back into it. Kaia received a master’s degree from the UNC Hussman School of Journalism, where she focused on reporting and science communication. She has published stories with Our State Magazine, Indy Week, and HuffPost. She most recently worked as the manager for a podcast on environmental sustainability and higher education. Her reporting passions include climate and the environment, health and science, food and women’s issues. When not working at WUNC, Kaia goes pebble-wrestling, takes long bike rides, and reads while hammocking.